Published July 17, 2013
For obese patients with Type 1 diabetes, a key measure of diabetes control improves when liraglutide is added to insulin, according to a new University at Buffalo study.
“This study is extremely relevant as most patients with Type 1 diabetes are poorly controlled and approximately 40 percent of Type 1 diabetics are obese,” says first author Nitesh D. Kuhadiya, MD, MPH, clinical assistant professor of medicine who conducted the study as a UB endocrinology fellow.
The study builds on previous UB research that demonstrates significant benefits for well-controlled Type 1 diabetics.
Through their retrospective data analysis, the researchers found that liraglutide helped 20 out of 27 patients reduce HbA1c. This measure of average blood glucose levels over three months is a key indicator of diabetes control.
Patients with a higher baseline HbA1c demonstrated greater reduction in this measure.
“In an obese group of patients with Type 1 diabetes, the fact that 74 percent demonstrated a significant reduction in HbA1c is important,” notes senior author Paresh Dandona, MD, PhD, SUNY Distinguished Professor of medicine and chief of endocrinology, diabetes and metabolism.
The study also found improvements in several other health measures after six months of the combination therapy.
“Patients achieved reductions in four-week average blood glucose concentrations, insulin dose, systolic blood pressure and body weight,” says Ritu Malik, MD, the key investigator of the study from Rochester General Hospital.
In addition, liraglutide did not increase incidence of hypoglycemia (low blood sugar), says Malik.
The study shows that liraglutide can help improve indicators of metabolic or insulin resistance syndrome, a combination of medical disorders that increases the risk of developing cardiovascular disease.
In the United States, approximately 40 percent of patients similar to those in the study have metabolic syndrome, notes Kuhadiya.
Out of 19 study patients who were both obese and hypertensive, 17 showed improvements in three features of metabolic syndrome: glycemia, systolic blood pressure and body weight.
“The combined reduction of three key features of metabolic syndrome would be expected to reduce future cardiovascular risk,” Kuhadiya says.
However, these benefits require further investigation, and need to be confirmed with robust, randomized clinical trials, the researchers caution.
Dandona and Kuhadiya are currently leading four such trials.
The study, “Liraglutide As Additional Treatment to Insulin in Obese Patients with Type 1 Diabetes Mellitus,” has been published in Endocrine Practice by the American Association of Clinical Endocrinologists.
UB coauthors are Antoine Makdissi, MD, clinical assistant professor of medicine, and Natalie Bellini, RN. Colleagues from Rochester General Hospital and St. John Fisher College also contributed.